Just bought a pair and used them on a 5 day hunt/hike in the Alpine Lakes wilderness. Love Altra’s and these did great with 1 exception. They are not water proof. Water gets in around the tongue and once they are wet they take a camp fire to get them dry.
Just read a review on the 4 RSMs and...
For your med kit I would add a a tourniquet. A CAT gen7 weighs 4 oz. You can make shift one out of many items in your kit but will you have the time and the mental capacity if you need one.
I would avoid the really cheap ones as they can fail. North American Rescue makes a quality one for...